WO2007081246A1 - Fil de mesure implantable - Google Patents

Fil de mesure implantable Download PDF

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Publication number
WO2007081246A1
WO2007081246A1 PCT/SE2006/000046 SE2006000046W WO2007081246A1 WO 2007081246 A1 WO2007081246 A1 WO 2007081246A1 SE 2006000046 W SE2006000046 W SE 2006000046W WO 2007081246 A1 WO2007081246 A1 WO 2007081246A1
Authority
WO
WIPO (PCT)
Prior art keywords
lead
heart
sensing elements
person
cardiac activity
Prior art date
Application number
PCT/SE2006/000046
Other languages
English (en)
Inventor
Sven-Erik Hedberg
Per Lagercrantz
Original Assignee
St. Jude Medical Ab
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by St. Jude Medical Ab filed Critical St. Jude Medical Ab
Priority to US12/160,666 priority Critical patent/US8133186B2/en
Priority to PCT/SE2006/000046 priority patent/WO2007081246A1/fr
Priority to EP06700428A priority patent/EP1979041A4/fr
Publication of WO2007081246A1 publication Critical patent/WO2007081246A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N2001/0585—Coronary sinus electrodes

Definitions

  • the present invention relates to an implantable sensor lead for sensing mechanical cardiac activity of a person, to an electronic device, an implantable cardiac stimulator as well as a method for sensing mechanical cardiac activity of a person.
  • Sensor signals can be used for such purposes as optimization of biventricular synchronization or setting the AV-delay in connection with cardiac stimulation, diagnosis of congestive heart failure, etc.
  • Leads comprising mechanical sensor elements like accelerometers, pressure sensing elements, strain gauges or tensiometers, often suffer from disturbances caused by local forces acting on the sensor elements.
  • a sensor element placed on e.g. the left side of the heart in a coronary vein is heavily influenced by local forces close to the sensor element.
  • CMES - sensors Cardio Mechanical Sensors, placed in the right ventricle, in coronary sinus, in great cardiac vein or in a coronary vein.
  • the placement of the sensor element of a cardiac sensor are seldom freely selectable.
  • Sensing elements having a certain extension are previously known as well as the use of more than one sensing element spread out over a part of the heart.
  • the tensiometric element consists of piezoelectric material or a variable resistivity material, the mechanical stresses to which the tensiometric element is subjected causing the element to produce a voltage or resistivity variation.
  • the tensiometric element is disposed at a location which is subject to bending when the heart contracts.
  • the tensiometric element may be in the form of a strip disposed on a surface of a patch electrode, or a strip or a tube located at the bend of an implantable J-shaped pacing lead.
  • US 5 423 883 discloses an implantable myocardial lead.
  • At the distal end of the lead a plurality of appendages are disposed. These appendages are intended to embrace the tissue of the heart and will flex forward and backward to move with the tissue of the heart.
  • At least one sensor element like a piezoelectric crystal or an accelerometer, is secured to an appendage for detecting the heart wall motion.
  • implantable leads incorporating accelerometer-based cardiac wall sensors are described.
  • the sensed cardiac wall motion is used to discriminate among potentially malignant cardiac arrhythmias.
  • the cardiac wall motion sensor may be incorporated in a flexible epicardial patch electrode or be incorporated in an endocardial lead.
  • the purpose of the present invention is to solve the above discussed problem related to disturbances caused by local forces acting on the sensor element when sensing mechanical cardiac activity.
  • an implantable sensor lead according to claim 1 by an electronic device according to claim 9 to which the mentioned lead is connectable, by an implantable heart stimulator according to claim 13 comprising such an electronic device, and by a method for sensing mechanical cardiac activity of a person according to claim 15.
  • the cardiac activity is sensed over a larger part or in a larger volume of the heart.
  • the resulting global signals obtained by such a spread out sensing over a larger part or a larger volume of the heart will normally be in phase, whereas local signals often are more or less unsynchronised.
  • the sensing elements are connected in parallel between two conductors common to all sensing elements. With such an embodiment a sensor signal averaging will be obtained. Signals in phase will be added, while signals out of phase will be more or less reduced.
  • each sensing element of the plurality of sensing elements is connected to at least one conductor of its own. With such an embodiment it is possible to study the propagation of a mechanical cardiac activity, such as mechanical heart muscle contractions, pressure pulses, blood flow along a vein, by analysis of the pattern of electric signals from the plurality of sensing elements. Thus e.g. the cardiac activity propagation speed can be determined, since the distances along the lead body between the individual sensing elements are known.
  • FIG. 1 shows three different possible locations in a person's heart of a lead according to the invention
  • figure 4 is a block diagram illustrating the electric circuitry of a heart stimulator according to the invention.
  • Figure 1 shows a lead 2 implanted in a person's heart 4 with a plurality of sensing elements 6 located in the right ventricle 8 of the heart 4.
  • the sensing elements 6 are distributed along a part of the lead body for sensing cardiac activity from a larger part or a larger volume of the right ventricle 8
  • Figures 2 and 3 show two embodiments of the lead according to the invention implanted in a coronary vein 10 on the left side of the heart 4.
  • the lead 12 shown in figure 2 is provided with a plurality of sensing elements 14 distributed along a part of the lead body adapted for implantation in the Coronary sinus for sensing the movement of the valve plane of the heart 4. The movement of the valve plane can reveal diastolic heart failure.
  • the lead 18 shown in figure 3 is provided with a plurality of sensing elements 20 distributed along a part of the lead body adapted for sensing mechanical cardiac activity in the left ventricle 22 ofthe heart 4.
  • FIG. 4 is a block diagram illustrating the electric circuitry of a heart stimulator to which a lead according to the invention is connected.
  • the sensing elements 24 of the lead are electrically connected in parallel between two electric conductors 26, 28.
  • One of the conductors 26 is intended to conduct stimulation pulses, a stimulation electrode being schematically indicated at 27, and the other conductor 28 is arranged independent of the stimulation circuitry.
  • a sensor signal averaging is provided. By summing the signals in this way from each sensor signals in phase are added to the averaged signal, while signals out of phase will be more or less reduced. Global signals picked up from a larger volume of the heart are thus obtained on which signal local disturbances have only a minor influence.
  • each sensing element is equipped with its own conductor, or with at least one conductor of its own.
  • the heart simulator electric circuitry comprises, in addition to normal main circuitry 30, pacing and sensing circuitry 32 and sensor interface 34.
  • the conductor 26 is intended to conduct stimulation pulses, whereas the conductor 28 is independent of the pacing circuitry.
  • the summing of the signals will be performed in a summing means of electric sensor signal processing means in the sensor interface shown in figure 4 or in subsequent electric circuitry.
  • a pressure pulse or blood flow along a vein can be determined by adapting the sensor signal processing electronics to recognize electric signal patterns caused by progressive activation of the sensing elements along a lead by a propagating mechanical activity.
  • the speed of propagation of the activity can also be calculated since the distances between the individual sensing elements along the lead are known.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Biophysics (AREA)
  • Physiology (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L’invention concerne un fil de mesure implantable servant à mesurer l’activité cardiaque mécanique d’une personne. Le fil de mesure implantable (2) comporte une pluralité d’éléments de mesure (6) disposés le long d’un corps de mesure implantable pour mesurer l’activité cardiaque mécanique et générer des signaux de mesure électriques correspondants. Un dispositif électronique comprend des circuits électroniques de traitement de signaux de mesure électriques auxquels le fil (2) peut être relié. Un stimulateur cardiaque implantable incorpore un dispositif électronique de ce type. L’invention concerne également un procédé de mesure de l’activité cardiaque mécanique d’une personne dans une partie du cœur (4) de cette personne à l’aide d’une pluralité d’éléments de mesure (6) répartis dans ladite partie.
PCT/SE2006/000046 2006-01-12 2006-01-12 Fil de mesure implantable WO2007081246A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US12/160,666 US8133186B2 (en) 2006-01-12 2006-01-12 Implantable sensor lead
PCT/SE2006/000046 WO2007081246A1 (fr) 2006-01-12 2006-01-12 Fil de mesure implantable
EP06700428A EP1979041A4 (fr) 2006-01-12 2006-01-12 Fil de mesure implantable

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/SE2006/000046 WO2007081246A1 (fr) 2006-01-12 2006-01-12 Fil de mesure implantable

Publications (1)

Publication Number Publication Date
WO2007081246A1 true WO2007081246A1 (fr) 2007-07-19

Family

ID=38256565

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE2006/000046 WO2007081246A1 (fr) 2006-01-12 2006-01-12 Fil de mesure implantable

Country Status (3)

Country Link
US (1) US8133186B2 (fr)
EP (1) EP1979041A4 (fr)
WO (1) WO2007081246A1 (fr)

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0473070A2 (fr) 1990-08-24 1992-03-04 Bozidar Ferek-Petric Systèmes de stimulation cardiaque avec mesure de la force de contraction du coeur
WO1995003086A2 (fr) 1993-07-14 1995-02-02 Siemens Pacesetter, Inc. Electrodes implantables comprenant des capteurs de mouvement de la paroi cardiaque
US5423883A (en) 1993-07-14 1995-06-13 Pacesetter, Inc. Implantable myocardial stimulation lead with sensors thereon
EP0727242A2 (fr) 1995-02-17 1996-08-21 Pacesetter, Inc. Détecteur de mouvement chez un dispositif médical implantable
US5593430A (en) 1995-01-27 1997-01-14 Pacesetter, Inc. Bus system for interconnecting an implantable medical device with a plurality of sensors
US5676153A (en) 1996-02-16 1997-10-14 Smith; Joseph M. System and method for determining spatial organization of atrial activation
US5999848A (en) * 1997-09-12 1999-12-07 Alfred E. Mann Foundation Daisy chainable sensors and stimulators for implantation in living tissue
US20030199957A1 (en) * 2002-04-22 2003-10-23 Chester Struble Organizing data according to cardiac rhythm type
US20040193021A1 (en) 2002-12-11 2004-09-30 Proteus Biomedical, Inc., A Delaware Corporation Method and system for monitoring and treating hemodynamic parameters
US20050090870A1 (en) * 2003-10-24 2005-04-28 Hine Douglas S. Reconfigurable, fault tolerant multiple-electrode cardiac lead systems

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5137047A (en) 1990-08-24 1992-08-11 Mark George Delivery of reactive gas from gas pad to process tool
US5243883A (en) * 1992-09-14 1993-09-14 Savage Dave W Clamping jaw projectors
WO2006042039A2 (fr) * 2004-10-08 2006-04-20 Proteus Biomedical, Inc. Tomographies a champ en continu

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0473070A2 (fr) 1990-08-24 1992-03-04 Bozidar Ferek-Petric Systèmes de stimulation cardiaque avec mesure de la force de contraction du coeur
WO1995003086A2 (fr) 1993-07-14 1995-02-02 Siemens Pacesetter, Inc. Electrodes implantables comprenant des capteurs de mouvement de la paroi cardiaque
US5423883A (en) 1993-07-14 1995-06-13 Pacesetter, Inc. Implantable myocardial stimulation lead with sensors thereon
US5628777A (en) * 1993-07-14 1997-05-13 Pacesetter, Inc. Implantable leads incorporating cardiac wall acceleration sensors and method of fabrication
US5593430A (en) 1995-01-27 1997-01-14 Pacesetter, Inc. Bus system for interconnecting an implantable medical device with a plurality of sensors
EP0727242A2 (fr) 1995-02-17 1996-08-21 Pacesetter, Inc. Détecteur de mouvement chez un dispositif médical implantable
US5676153A (en) 1996-02-16 1997-10-14 Smith; Joseph M. System and method for determining spatial organization of atrial activation
US5999848A (en) * 1997-09-12 1999-12-07 Alfred E. Mann Foundation Daisy chainable sensors and stimulators for implantation in living tissue
US20030199957A1 (en) * 2002-04-22 2003-10-23 Chester Struble Organizing data according to cardiac rhythm type
US20040193021A1 (en) 2002-12-11 2004-09-30 Proteus Biomedical, Inc., A Delaware Corporation Method and system for monitoring and treating hemodynamic parameters
US20050090870A1 (en) * 2003-10-24 2005-04-28 Hine Douglas S. Reconfigurable, fault tolerant multiple-electrode cardiac lead systems

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP1979041A4

Also Published As

Publication number Publication date
EP1979041A1 (fr) 2008-10-15
US8133186B2 (en) 2012-03-13
US20090253993A1 (en) 2009-10-08
EP1979041A4 (fr) 2013-03-27

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